The Anatomical Basis of Paradoxical Masseteric Bulging after Botulinum Neurotoxin Type A Injection
<p>Photograph of paradoxical masseteric bulging. (Reproduced with permission from Seo K, Botulinum Toxin for Asians; Seoul Medical Publishing.)</p> "> Figure 2
<p>Detailed characteristics of the deep inferior tendon (DIT). (<b>A</b>) The DIT was located deep to the superficial muscle belly of the superficial part of the masseter. (<b>B</b>) The muscle fibers originated from the superficial aponeurosis of the masseter muscle, descended, and then changed into the tendon structure attaching to the inferior mandibular border. White arrowheads indicate the muscle fibers that originate from the deep to the superficial aponeurosis of the masseter muscle. A: anterior; S: superior; OOr: orbicularis oculi muscle.</p> "> Figure 3
<p>Classification of the DIT. The DIT can be found easily after removing the superficial muscle belly of the superficial part of the masseter. (<b>A</b>) Type A in which the DIT covers areas IV and V. (<b>B</b>) Type B in which the DIT covers areas V and VI. (<b>C</b>) Type C in which the DIT covers areas IV, V, and VI.</p> "> Figure 4
<p>Proportions of the DIT in the superficial part of the masseter. The surface area of the superficial part of the masseter muscle was 22.22 ± 4.2 cm<sup>2</sup> (<b>A</b>), and the DIT area within the masseter muscle was 4.48 ± 2.2 cm<sup>2</sup> (<b>B</b>), hence constituting 22% of the superficial part of the masseter.</p> "> Figure 4 Cont.
<p>Proportions of the DIT in the superficial part of the masseter. The surface area of the superficial part of the masseter muscle was 22.22 ± 4.2 cm<sup>2</sup> (<b>A</b>), and the DIT area within the masseter muscle was 4.48 ± 2.2 cm<sup>2</sup> (<b>B</b>), hence constituting 22% of the superficial part of the masseter.</p> "> Figure 5
<p>Serial dissections of the layered structures of the masseter muscle from superficial to deep. (<b>A</b>) Surfaces of the superficial part of the masseter. (<b>B</b>) The DIT was exposed after removing the superficial muscle belly and the aponeurosis of the superficial part of the masseter. (<b>C</b>) Another muscle belly was revealed after removing the DIT. (<b>D</b>) The middle and deep parts of the masseter muscle were attached at the lateral surface of the mandible and the periosteum.</p> "> Figure 6
<p>The illustration of the coronal section of the masseter from superficial to deep (<b>A</b>) and the expected muscle feature showing the masseteric bulging after the BTX-A injection into the masseter muscle during clenching (<b>B</b>). When masseter contracts, paradoxical masseteric bulging may occur at the superficial belly of the superficial part of the masseter because the DIT blocks the toxin’s diffusion. (SB: superficial muscle belly of superficial part of the masseter; DB: deep muscle belly of superficial part of the masseter; DP: deep part of the masseter; DIT: deep inferior tendon; SaM: superficial aponeurosis of the masseter).</p> ">
Abstract
:1. Introduction
2. Results
3. Discussion
4. Materials and Methods
Acknowledgments
Author Contribution
Conflicts of Interest
References
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Lee, H.-J.; Kang, I.-W.; Seo, K.K.; Choi, Y.-J.; Kim, S.-T.; Hu, K.-S.; Kim, H.-J. The Anatomical Basis of Paradoxical Masseteric Bulging after Botulinum Neurotoxin Type A Injection. Toxins 2017, 9, 14. https://doi.org/10.3390/toxins9010014
Lee H-J, Kang I-W, Seo KK, Choi Y-J, Kim S-T, Hu K-S, Kim H-J. The Anatomical Basis of Paradoxical Masseteric Bulging after Botulinum Neurotoxin Type A Injection. Toxins. 2017; 9(1):14. https://doi.org/10.3390/toxins9010014
Chicago/Turabian StyleLee, Hyung-Jin, In-Won Kang, Kyle K. Seo, You-Jin Choi, Seong-Taek Kim, Kyung-Seok Hu, and Hee-Jin Kim. 2017. "The Anatomical Basis of Paradoxical Masseteric Bulging after Botulinum Neurotoxin Type A Injection" Toxins 9, no. 1: 14. https://doi.org/10.3390/toxins9010014
APA StyleLee, H. -J., Kang, I. -W., Seo, K. K., Choi, Y. -J., Kim, S. -T., Hu, K. -S., & Kim, H. -J. (2017). The Anatomical Basis of Paradoxical Masseteric Bulging after Botulinum Neurotoxin Type A Injection. Toxins, 9(1), 14. https://doi.org/10.3390/toxins9010014